Visceral leishmaniasis among hypersplenic patients in Dakahlia Governorate, Egypt.

Generally speaking, with rapid international travel, it is very common to diagnose infectious diseases in areas where they were not known before. Nowadays, visceral leishmaniasis (VL) is documented in Egypt mainly in Al Agamy, Alexandria. Another case of infantile visceral leishmaniasis was identified in an adult farmer (unusual host) in Banha. Other studies all over Egypt (based on clinical and or serological diagnosis rather than demonstration of the parasites) raised the possibility of adult affection with visceral leishmaniasis. The point is that visceral leishmaniasis, shares many clinical manifestations with other diseases known in Egypt as schistosomiasis mansoni, hepatic amoebiasis, toxoplasmosis, and malaria. In the present study, out of 22 human cases with hypersplenism and suggesting manifestations, four gave seropositivity for VL, by the indirect haemagglutination tests (128 & more). Two of these four patients gave seropositivity by dot-ELISA (1:8000). Amastigotes of Leishmania parasite were demonstrated in the splenic smears obtained during splenectomy. One culture obtained from these two cases grew promastigotes. Typing is ongoing. It was concluded that visceral leishmaniasis should be in mind and considered in the differential diagnosis of patients with hepatosplenomegaly or hypersplenism in Egypt.